Hospital Dr News

Consultants set for bigger role in commissioning

The government is set to give hospital doctors a greater role in GP commissioning.

In his first major speech since the launch of the ‘listening exercise’ about the Health and Social Care Bill, Prime Minister David Cameron said the government is not paying lip service to feedback on the reforms.

He said: “We are listening and we will make substantive changes to improve the reforms, based on what we hear.

“I do not want to pre-empt what those changes will be…But it is clear for example, that when people working in our hospitals hear the term ‘GP commissioning’, they worry it’s only GPs that are going to be involved in making decisions. Now that’s not the case, but I agree we need hospital doctors and nurses to be much more closely engaged in commissioning.”

Cameron stressed that the current reform process was evolutionary rather than revolutionary – saying that foundation trusts, payment by results and clinical commissioning had all been around a long time.

“That’s why, when I think about what our NHS will look like in five years time, I don’t picture some space-age institution, a million miles away from what we have now,” he said. “Let me make clear: there will be no privatisation; there will be no cherry-picking from private providers; there will be no new upfront costs people have to pay to get care.”

He was also more diplomatic about the performance of the NHS than his health secretary has been – acknowledging the NHS is already getting better.

Cameron said: “I just think it’s time we had the confidence to say we should have some of the best health outcomes in Europe too. Saying this doesn’t make you anti-NHS, it makes you pro-NHS – because you want to make things better for everyone.”

Commenting on the speech, president of the RCS Mr John Black said: “The Royal College of Surgeons welcomes the Prime Minister’s commitment to amend the health reforms. The firm commitment to include hospital clinicians in the new NHS commissioning structure and prevent services being destabilised by cherry picking echo concerns raised by the RCS in consultation on the Bill.

“Surgeons also strongly endorse his view that patients are best served by being able to make clinically informed joint decisions with their GP and consultant about their care. The College feels that good, direct lines of communication between clinicians looking after individual patients provide the kind of personalised care the reforms seek to achieve.”

The Prime Minister highlighted the growing demands – of an increasingly obese, alcohol-abusing population – being placed on the NHS, and said that unreformed the NHS would need an unaffordable £130bn a year by 2015.

Dr Hamish Meldrum, chairman of BMA Council, commented: “We agree with the Prime Minister that the NHS needs to change. There needs to be greater integration, greater efficiency, and more emphasis on prevention.

“However, the Health Bill as it is currently written would make these improvements far harder to achieve, leading to a more fragmented health service, with many hospitals at risk of closure. Whilst we welcome his commitment to listening to staff and to taking them with him, most doctors will not feel able to support this Bill unless it is radically amended.”

Meldrum added: “Unfortunately the government has often ignored the advice of health organisations on how to tackle alcohol misuse and obesity, preferring to listen to and rely on the views of industries which have a vested interest in selling unhealthy products.”

The Future Forum, which  is advising the government on its NHS reforms, is due to report its findings in June. The government will respond with changes after that.

Read the full speech.

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